Challenges and leadership strategies for managers of nurse practitioners
Article first published online: 17 OCT 2003
Journal of Nursing Management
Volume 11, Issue 6, pages 396–403, November 2003
How to Cite
Reay, T., Golden-Biddle, K. and Germann, K. (2003), Challenges and leadership strategies for managers of nurse practitioners. Journal of Nursing Management, 11: 396–403. doi: 10.1046/j.1365-2834.2003.00412.x
- Issue published online: 17 OCT 2003
- Article first published online: 17 OCT 2003
- Accepted for publication: 16 May 2003
- nurse practitioners;
- nursing leadership;
- nursing management;
- organizational change
Aim The aim of this paper is to report on the findings from our research into the recent introduction of nurse practitioners in Alberta, Canada. Through an organizational research perspective, we identify the critical role of health care managers in developing a sustainable nurse practitioner role.
Background Previous literature has focused on nurse practitioners themselves as the key factor in their integration into the health care system. Although they are qualified and organizationally well placed, managers of nurse practitioners have been overlooked as a critical part of implementation strategies.
Key issues We interviewed 25 nurse practitioners and seven of their managers. Through our data analysis we identified three major challenges for managers: (1) clarifying the reallocation of tasks; (2) managing altered working relationships within the team; (3) continuing to manage the team in an evolving situation. Associated with these challenges, we propose leadership strategies that managers may find useful as they work through the consequences of introducing the nurse practitioner role. These strategies are:
• encourage all team members to sort out ‘who does what’;
• ensure that task reallocation preserves job motivating properties;
• give consideration to how tasks have been allocated when issues identified as ‘personal conflict’ arise;
• pay attention to all perspectives of the working relationships within the team;
• facilitate positive relationships between team members;
• lead from a ‘balcony’ perspective;
• work with the team to develop goals that are not over focused on the nurse practitioner;
• regularly share with other managers the experiences and lessons learned in introducing nurse practitioners.
Conclusion For managers to be most effective, they need to address three challenges that are of a managerial, not clinical, nature. By implementing specific leadership strategies, managers of nurse practitioners can facilitate the introduction of the new role and improve its sustainability in health organizations.